Iodine-based radiographic contrast medium may precipitate metformin-associated lactic acidosis in diabetic patients. A case report, literature review and practical approach.

M Tonolini

Journal: La Clinica terapeutica 2012;163(1):59-62

PMID: 22362235

Full Text on Societa Editrice Universo, srl View on PubMed

Abstract

Lactic acidosis in diabetic patients undergoing metformin therapy is a widely recognized, rare but usually serious adverse event, particularly in presence of comorbidities such as cardiorespiratory disease, sepsis and renal failure. As demonstrated by the case of an elderly woman presented, administration of radiographic iodine-based contrast agents may precipitate lactic acidosis through worsening of renal function. Awareness of this condition, identification of at-risk patients, adequate prevention following published guidelines, early diagnosis and treatment including hemodialysis are necessary to avoid a fatal outcome.

Address: Radiology Department, Luigi Sacco Hospital, Milan, Italy. [email protected]

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MeSH Terms: Acidosis, Lactic, Aged, 80 and over, Atrial Fibrillation, Contraindications, Contrast Media, Creatinine, Diabetes Mellitus, Type 2, Emergencies, Fatal Outcome, Female, Heart Failure, Humans, Hypertension, Hypoglycemic Agents, Iodine Compounds, Kidney, Kidney Diseases, Metformin, Pulmonary Atelectasis, Renal Dialysis, Smoking, Tomography, Spiral Computed